Top Doctors 2010
From surgeons to psychiatrists, meet the Hudson Valley’s top 101 medical specialists — as reviewed by their peers and fellow physicians
(page 4 of 6)
Cyndi Miller, M.D.
A family legacy in science and teaching helped inspire Dr. Cyndi Miller to pursue her medical career.
“My father wanted to be a physician when he was a young man,” she explains. “He was what they then called a medic in World War II — not what they’re thought of today; he wasn’t in the battlefield, but at a hospital in Philadelphia, assisting surgeons in the operating room when wounded soldiers came in.”
Later, he became a microbiologist, “and actually, he made an amazing contribution to the world,” she says proudly. “He developed a medication called ivermectin that prevents river blindness, a disease that used to blind millions of people, especially in Africa. The drug company Merck has been giving it away free for decades now. So there’s a science background in our family.” And her mom was a teacher, as were several other relatives.
This background inspired Miller to combine her medical training with a love of teaching. She does both at Albany Medical Center, where she’s now based, heading up the hospital’s HIV clinic.
She grew up in New Jersey, went to Duke University, and got her medical degree at Bowman Gray School of Medicine, now part of Wake Forest University in North Carolina. She then did her internal medicine residency at a Yale Hospital affiliate in Greenwich, Connecticut.
Miller came to her career in the HIV field by chance, she explains. “In the mid-1980s, right after I finished my residency, my husband, who’s also a doctor, was getting ready to go to medical school in Minnesota the next year.”
With 12 months free before the move west, she kept an eye out for a temporary medical position. “One day, I read a magazine article about how Montefiore Hospital in the Bronx was treating a growing number of AIDS patients. That was back when the epidemic was just starting to get public awareness. I wrote a letter to them, basically saying, ‘Do you need help? I’m available.’ They said, ‘Yes, we do need help!’ So I went, and began working in the AIDS field. I knew right away it was a good fit for me.”
Treatment was in its infancy in those days, she recalls. “Some people were still afraid to touch AIDS patients, not being sure how it was transmitted. But Montefiore was in the vanguard of those who clearly established that AIDS couldn’t be transferred by casually touching someone.
“At that time, all we could do for treatment was basically order an HIV test to measure T-cells” (the white blood cells linked to the body’s level of immunity). “The first year I started, the drug ADT was approved. But it wasn’t an easy time; patients would get better for a while, then often their bodies would basically just fail.” Miller says that in those early days, the hospital would be treating 30 to 35 AIDS patients at a time. “And that number kept growing — fast.”
She adds: “There are people whose names, and medical stats, and what they died from, are still in my mind on a regular basis. It was tough work, but I had the feeling of being at home with what I was doing. I was helping others; that made it easier.”
Miller and her husband moved to Minnesota while he studied at the Mayo Clinic; meanwhile, she did a fellowship in infectious diseases at the University of Minnesota. They returned east in 1991, and she’s been with Albany Medical Center ever since.
“We serve about 1,500 patients now at the Albany clinic; people often don’t realize how high the number is.” They see patients of all ethnic groups, and all ages. “We’ve even had patients in their 80s.”
The treatment for HIV has evolved dramatically, she says. “Strong medication came out in the late 1990s, and most of our patients now live a normal lifespan. The majority, even when they are ill, can now be helped. But you don’t want to wait that long for a diagnosis of HIV. People can go up to 12 years being infected, without being identified as HIV-positive, in normal circumstances. We try to treat people before then. And just because we now have medications, doesn’t mean people shouldn’t be careful and not practice safe sex.”
Her central medical message is twofold, Miller says: “First, you’ve absolutely got to know your own and your partner’s sexual history to be safe if you’re not going to use condoms. Second, we’re recommending that physicians test every sexually active adult once in their lives for HIV. The test is cheap and easy, and can be done along with a regular blood test. Of course, anyone at high risk should be tested as often as necessary.”
Miller says her team generally sees their HIV patients every three or four months. “I have people I’ve been following now for 15 to 19 years. We’re like old pals.” Yet the inevitable deaths are still tough to handle, she admits. “We see about 30 to 40 deaths a year. Every one is a tragedy. Even if they die from something else, a stroke or heart attack — they were all HIV patients, and all someone you’ve known and cared about.”
To help ease the stress of her career, Miller says she loves to relax with gardening. She and her husband have two children; a daughter, 15, and a son who’s 20. “Neither of them are interested in going into a medical career,” she laughs. “They say their father and I both work too hard.”
Even though her field can be emotionally grueling, Miller says it’s extremely satisfying. “The most exciting thing is the first time a patient realizes how much better they feel after they’re on medication. They come in and say their energy is back, their skin rash is gone, their hair is growing, and they feel like a person again. Then we get to tell them their tests show they’re doing well and their T-cells are up 200 points. They’re so happy. We can tell them they’re now dealing with treating a chronic condition, and that they’re going to survive — they’re going to make it.”